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https://www.readbyqxmd.com/read/29679639/decoding-fibrosis-mechanisms-and-translational-aspects
#1
Liliana Schaefer
Fibrosis, a complex process of abnormal tissue healing which inevitably leads to loss of physiological organ structure and function, is a world-wide leading cause of death. Despite a large body of research over the last two decades, antifibrotic approaches are mainly limited to organ replacement therapy generating high costs of medical care. In this translational issue, a unique group of basic and clinical researchers provide meaningful answers to a desperate call of society for effective antifibrotic treatments...
April 18, 2018: Matrix Biology: Journal of the International Society for Matrix Biology
https://www.readbyqxmd.com/read/29673374/why-is-announcement-training-more-effective-than-conversation-training-for-introducing-hpv-vaccination-a-theory-based-investigation
#2
Teri L Malo, Megan E Hall, Noel T Brewer, Christine R Lathren, Melissa B Gilkey
BACKGROUND: Improving healthcare providers' communication about HPV vaccination is critical to increasing uptake. We previously demonstrated that training providers to use presumptive announcements to introduce HPV vaccination improved uptake, whereas training them to use participatory conversations had no effect. To understand how communication training changed provider perceptions and communication practices, we evaluated intermediate outcomes and process measures from our randomized clinical trial, with a particular focus on identifying mechanisms that might explain the announcement training's impact...
April 19, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29672869/age-of-transfused-blood-in-critically-ill-adult-trauma-patients-a-prespecified-nested-analysis-of-the-age-of-blood-evaluation-randomized-trial
#3
Robert S Green, Mete Erdogan, Jacques Lacroix, Paul C Hébert, Alan T Tinmouth, Elham Sabri, Tinghua Zhang, Dean A Fergusson, Alexis F Turgeon
BACKGROUND: Blood transfusion is common in the resuscitation of patients with traumatic injury. However, the clinical impact of the length of storage of transfused blood is unclear in this population. STUDY DESIGN AND METHODS: We undertook a prespecified nested analysis of 372 trauma victims of the 2510 critically ill patients from 64 centers treated as part of the Age of Blood Evaluation (ABLE) randomized controlled trial. Patients were randomized according to their trauma status to receive either a transfusion of fresh blood stored not more than 7 days or standard-issue blood...
April 19, 2018: Transfusion
https://www.readbyqxmd.com/read/29668542/clinical-trial-enrollment-is-associated-with-improved-follow-up-rates-among-survivors-of-childhood-cancer
#4
Kelley K Hutchins, Süreyya Savaşan, Ronald L Thomas, Laura A Strathdee, Zhihong J Wang, Jeffrey W Taub
Fortunately >80% of children diagnosed with cancer become long-term survivors; however, this population is at a significantly increased risk of morbidity and mortality as a result of their previous cancer therapy, and long-term follow-up (LTFU) is critical. Multiple barriers to receiving adequate LTFU care have been studied. We investigated whether lack of enrollment in a therapeutic clinical trial may be a barrier to receiving LTFU care. We conducted a review of 353 patient records at the Children's Hospital of Michigan enrolled in our Children's Oncology Group registry between January 1, 2005 and December 31, 2010...
April 17, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29666934/quo-vadis-do-immunotherapies-have-a-role-in-glioblastoma
#5
REVIEW
Sylvia C Kurz, Patrick Y Wen
PURPOSE OF REVIEW: More effective therapies for glioblastoma are urgently needed. Immunotherapeutic strategies appear particularly promising and are therefore intensively studied. This article reviews the current understanding of the immunosuppressive glioblastoma microenvironment, discusses the rationale behind various immunotherapies, and outlines the findings of several recently published clinical studies. RECENT FINDINGS: The results of CheckMate-143 indicated that nivolumab is not superior to bevacizumab in patients with recurrent glioblastoma...
April 18, 2018: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/29666811/immune-checkpoint-pathways-in-non-small-cell-lung-cancer
#6
REVIEW
Young Kwang Chae, Ayush Arya, Wade Iams, Marcello Cruz, Nisha Mohindra, Victoria Villaflor, Francis J Giles
Immunotherapy has evolved at a phenomenal pace in cancer therapeutics. This has primarily been fueled by the much perceived necessity to procure an alternative to current standard of care chemotherapy agents, owing to several concerns such as treatment-related toxicity and poor long-term survival associated with the same. The knowledge of various mechanisms involved in regulation of immune response to cancer cells has served a fundamental role in identifying key molecules through which immune cell activity may be modulated...
March 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29666801/current-therapeutic-landscape-for-advanced-gastroesophageal-cancers
#7
REVIEW
Anthony Lopez, Kazuto Harada, Dilsa Mizrak Kaya, Jaffer A Ajani
Treatment of advanced gastroesophageal cancers remains challenging for clinicians, patients, and caregivers alike. Despite considerable research, the therapeutic armamentarium is restricted and hardly personalized. In the first-line setting, trastuzumab with a fluoropyrimidine and platinum agent is the standard-of-care in patients with HER2-positive tumor. For the others, a platinum-based doublet (preferably with oxaliplatin) is recommended. Three-drug cytotoxic regimens should be reserved for exceptional cases where patients have good performance status...
February 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29666295/lung-ultrasound-prior-to-spontaneous-breathing-trial-is-not-helpful-in-weaning-the-decision-making-process
#8
Ana Carolina P Antonio, Marli M Knorst, Cassiano Teixeira
BACKGROUND: Lung ultrasound is increasingly becoming a diagnostic tool in the critical care setting. B-pattern on a lung ultrasound is an artifact composed of multiple B-lines and correlates with interstitial edema. A randomized controlled trial concluded that bedside thoracic ultrasound could predict postextubation distress through changes in lung aeration during a weaning procedure; however, it could not screen patients before performance of a spontaneous breathing trial (SBT). METHODS: We conducted a 2-year, prospective, multicenter, observational study in 2 adult medical-surgical ICUs in southern Brazil...
April 17, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29666199/does-magnesium-sulfate-have-a-role-in-the-management-of-severe-traumatic-brain-injury-in-civilian-and-military-populations-a-systematic-review-and-meta-analysis
#9
REVIEW
Marc W H Lyons, W J Blackshaw
INTRODUCTION: Traumatic brain injury (TBI) is a significant cause of combat morbidity. Currently, the medical management of TBI is limited to supportive critical care. Magnesium sulfate has been studied as a potentially beneficial therapeutic agent. METHODS: A systematic review and meta-analysis was undertaken, examining the role of magnesium in the management of severe TBI in adults. The primary outcome of the study was all-cause mortality, with secondary outcomes of Glasgow Outcome Score (GOS) and GCS...
April 17, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29665019/evidence-based-medicine-for-every-day-everyone-and-every-therapeutic-study
#10
REVIEW
Raghav Govindarajan, Pushpa Narayanaswami
The rapid growth in published medical literature makes it difficult for clinicians to keep up with advances in their fields. This may result in a cursory scan of the abstracts and conclusions of a study without critically evaluating study quality. The application of Evidence-Based Medicine (EBM) is the process of converting the abstract task of reading the literature into a practical method of using the literature to inform care in a specific clinical context while simultaneously expanding one's knowledge. EBM involves 4 steps: stating the clinical problem in a defined question; searching the literature for the evidence; critically appraising the evidence for its validity and applying the evidence in the context of the patient's situation, preferences and values...
April 17, 2018: Muscle & Nerve
https://www.readbyqxmd.com/read/29663837/immune-checkpoint-blockade-in-advanced-hepatocellular-carcinoma-an-update-and-critical-review-of-ongoing-clinical-trials
#11
James J Harding
Systemic treatments for advanced hepatocellular carcinoma (HCC) are evolving rapidly and several multi-targeted tyrosine kinase inhibitors have demonstrated a survival advantage over best supportive care. Despite these treatment advances, the majority of HCC patients will progress on tyrosine kinase inhibitor therapy. Preclinical data indicate that interference with immune checkpoint molecules results in HCC growth suppression. Several clinical trials applying monoclonal antibodies to immune checkpoint molecules have demonstrated durable antitumor activity in advanced HCC patients...
April 17, 2018: Future Oncology
https://www.readbyqxmd.com/read/29661225/lymphocyte-subset-expression-and-serum-concentrations-of-pd-1-pd-l1-in-sepsis-pilot-study
#12
Julie K Wilson, Yuan Zhao, Mervyn Singer, Jo Spencer, Manu Shankar-Hari
BACKGROUND: Sepsis remains a major cause of mortality in critical care, for which specific treatments are lacking. The dysregulated response to infection seen in sepsis includes features of lymphocyte dysfunction and exhaustion, suggesting that immune-stimulatory therapy may improve outcomes in certain patient groups. Monoclonal antibodies targeting checkpoint molecules, such as programmed-death 1 protein (PD-1) and its ligand PD-L1, have shown success in stimulating the immune response in patients with cancer, and are being considered for future sepsis trials...
April 17, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29659676/methodology-of-clinical-trials-evaluating-the-incorporation-of-new-drugs-in-the-first-line-treatment-of-patients-with-diffuse-large-b-cell-lymphoma-dlbcl-a-critical-review
#13
G Iacoboni, E Zucca, M Ghielmini, A Stathis
Purpose: The first line treatment of diffuse large B-cell lymphoma (DLBCL) is the combination of rituximab with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy, curing approximately 60% of patients. Many clinical trials have been performed over the last 10 years trying to improve the results of this treatment, but the appropriateness of their planning strategies could be rediscussed. Patients and Methods: Reports of phase 3 trials evaluating the addition of molecularly targeted agents (MTA) or new monoclonal antibodies to the classic R-CHOP backbone in first-line induction or maintenance treatment were reviewed...
April 5, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29658485/hyperbaric-oxygen-therapy-its-use-in-medical-emergencies-and-its-development-in-hong-kong
#14
J Ks Leung, R Pk Lam
Hyperbaric oxygen therapy is widely accepted as life-saving treatment for decompression illness. Yet its use in acute carbon monoxide poisoning has remained controversial because of inconsistent findings in clinical trials. Hyperbaric oxygen therapy has an adjunctive role in managing gas gangrene, necrotising soft-tissue infection, and crush injury, as supported by case series. Several cases have been reported in the literature detailing the use of hyperbaric oxygen therapy in patients with severe anaemia in whom blood transfusion is not possible...
April 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29656306/oral-and-sublingual-immunotherapy-for-treatment-of-ige-mediated-food-allergy
#15
REVIEW
Amy M Scurlock
Development of active therapies for IgE-mediated food allergy is a critical action step toward alleviating the adverse medical, psychosocial, and economic burdens on affected patients and families. Significant progress has been observed specifically in the application of single-allergen oral and sublingual immunotherapy for treatment of IgE-mediated food allergy, with emphasis on milk, egg, and peanut as the primary allergens. Oral immunotherapy (OIT) has demonstrated efficacy in promoting immunomodulatory effects that lead to the clinical outcome of desensitization, defined as reduced reactivity while on active OIT, in the majority of treated individuals; however, achievement of sustained unresponsiveness following cessation of therapy has been observed in a smaller subset of treated subjects...
April 14, 2018: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/29655672/effect-of-pulsed-xenon-ultraviolet-room-disinfection-devices-on-microbial-counts-for-methicillin-resistant-staphylococcus-aureus-and-aerobic-bacterial-colonies
#16
John E Zeber, Christopher Pfeiffer, John W Baddley, Jose Cadena-Zuluaga, Eileen M Stock, Laurel A Copeland, Janet Hendricks, Jwan Mohammadi, Marcos I Restrepo, Chetan Jinadatha
BACKGROUND: Inadequate environmental disinfection represents a serious risk for health care-associated infections. Technologic advancements in disinfection practices, including no-touch devices, offer significant promise to improve infection control. We evaluated one such device, portable pulsed xenon ultraviolet (PX-UV) units, on microbial burden during an implementation trial across 4 Veterans Affairs hospitals. METHODS: Environmental samples were collected before and after terminal room cleaning: 2 facilities incorporated PX-UV disinfection into their cleaning protocols and 2 practiced manual disinfection only...
April 11, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29653344/a-randomized-controlled-trial-of-comprehensive-early-intervention-care-in-patients-with-first-episode-psychosis-in-japan-1-5-year-outcomes-from-the-j-cap-study
#17
Atsushi Nishida, Shuntaro Ando, Syudo Yamasaki, Shinsuke Koike, Kayo Ichihashi, Yuji Miyakoshi, Sanae Maekawa, Tomohisa Nakamura, Tatsunobu Natsubori, Eriko Ichikawa, Hiroki Ishigami, Kojiro Sato, Asami Matsunaga, Jo Smith, Paul French, Hirohiko Harima, Yoshiki Kishi, Izumi Fujita, Kiyoto Kasai, Yuji Okazaki
The first episode of psychosis represents a critical period wherein comprehensive early intervention in psychosis (EIP) may alter the course of illness. However, evidence from randomized controlled trials that have examined the impact of comprehensive EIP care on clinical and functional recovery assessed by independent blinded raters is limited. The objective of this study was to conduct a single-blinded multicenter trial comparing comprehensive EIP care and standard care in young patients with first-episode psychosis (FEP) in Japan (J-CAP Study)...
April 8, 2018: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/29652744/clinical-pearls-part-3-anaesthetic-management-of-abnormally-invasive-placentation
#18
Vinod Patil, Gamunu Ratnayake, Galina Fastovets, D S Wijayatilake
PURPOSE OF REVIEW: Abnormal placentation is a clinical condition seen increasingly in the pregnant population. It is associated with significant morbidity and mortality, which may be mitigated through robust multidisciplinary care for these patients. The role of maternal critical care for these patients has largely been ignored in the literature. RECENT FINDINGS: Advances in pharmacological management of bleeding with recent publications of large multicentre trials in addition to new technologies in the management of massive obstetric haemorrhage (MOH) have revolutionized the management of abnormal placentation...
April 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29650485/providing-transthoracic-echocardiography-training-for-intensive-care-unit-trainees-an-educational-improvement-initiative
#19
Catherine M Kuza, M Tariq Hanifi, Melissa Koç, Matthias Stopfkuchen-Evans
OBJECTIVE: Transthoracic echocardiography (TTE) is important in the management of critically ill patients, yet it has not been incorporated into many residency programs' curricula. Our objective is to determine if trainees undergoing a 60-minute training session on TTE have improved knowledge, ultrasound skills, and increases the utilization of TTE during their rotation in the intensive care unit (ICU). We will also compare the results of participants with prior TTE exposure to TTE-naïve trainees...
April 9, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29644145/publicly-reported-wound-healing-rates-the-fantasy-and-the-reality
#20
REVIEW
Caroline E Fife, Kristen A Eckert, Marissa J Carter
Significance: We compare real-world data from the U.S. Wound Registry (USWR) with randomized controlled trials and publicly reported wound outcomes and develop criteria for honest reporting of wound outcomes, a requirement of the new Quality Payment Program (QPP). Recent Advances: Because no method has existed by which wounds could be stratified according to their likelihood of healing among real-world patients, practitioners have reported fantastically high healing rates. The USWR has developed several risk-stratified wound healing quality measures for diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs) as part of its Qualified Clinical Data Registry (QCDR)...
March 1, 2018: Advances in Wound Care
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